Meeting Future Health Needs Now

Peter Layde, MD, MSc, knew that Wisconsin faced a coming shortage of health care and public health workers. Through a 2007 Healthier Wisconsin Partnership Program (HWPP) project, he collaborated with the Wisconsin Public Health Association to organize a public health summit.

“At the summit,” Layde said, “we got leaders in public health from around the state to commit to improving the adequacy, diversity and competency of the public health workforce.”

What Layde did not know at the time was the scope of the problem. No one did. So he was not surprised when he received a call from Tim Size, executive director of the Rural Wisconsin Health Cooperative.

“He had been coordinating a group very interested in coming up with better data on the public health workforce,” Layde said. “There was also a task force through state government that sought to improve health care and public health employment in Wisconsin. There were a lot of people interested in that, the Wisconsin Hospital Association, rural health care providers, the Wisconsin Center for Nursing, Wisconsin Medical Society, many, many different groups.”

But, the state had no system in place to gather the data needed to inform these types of initiatives.

“They realized that they were basically working in the dark,” Layde said, “because they didn’t have any ideas about the future needs for health care professionals and public health professionals.”

The Wisconsin Health Workforce Data Collaborative received funding from HWPP in 2009 to respond to this need for data to guide decisions on education, training and recruitment efforts. HWPP is a component of the Advancing a Healthier Wisconsin Endowment, a fund with the mission of improving the health of the people of Wisconsin.

While the Collaborative focused on a number of professions related to health care and public health, a major initiative was to better understand the state of the aging nursing workforce.

“Many nurses are getting to the point where they anticipate retiring in the next five years,” Layde said, “but there are not adequate numbers of new nurses being trained to care for the aging baby boomers as their health care needs increase.”

The partnerships developed through the course of this project were vital to studying this issue.

“All of the partners really committed,” Layde said, “so we could leverage the AHW funding by doing things through our partners. For example, at minimal cost, we were able to deliver a survey to all of the nurses who were applying for licensure through the re-licensure process. As a free-standing survey, to get a 70 percent response rate, it would have cost more than the entire budget of the project. And we got very close to 50,000 nurses surveyed.”

The data from this survey allowed the Collaborative to define the scope of the looming nurse shortage. Without significant changes in the numbers of nurses graduating in Wisconsin, the data analysts found that the state will be short more than 5,000 nurses by 2020 and more than 20,000 nurses by 2035.

The project partners’ findings also demonstrated a number of other conditions in the nursing workforce.

“The report,” Layde said, “redoubled the emphasis on the importance of increasing the supply of nursing educators if we want to have more programs to train nurses in Wisconsin.”

In addition to the need for more nursing educators, the report also found sizeable regional disparities and a lack of racial, ethnic and cultural diversity.

“It is difficult,” Layde said, “to get someone from Milwaukee to move up to Ladysmith, or for someone from Ladysmith to move to Milwaukee. We were trying to address that. An emerging idea for increasing the supply of nurses in rural hospitals is to boost recruitment efforts to get more students from rural areas to enter nursing school.”

While nursing was a major focus, the project partners helped address health professional shortages in other ways, including providing information to help counties apply for and secure Health Professional Shortage Designation Area (HPSA) status.

“Communities that get this special designation,” Layde said, “can do a lot of things to address their workforce shortages. People who get subsidized education through the federal government can get a loan forgiveness program if they work in one of these communities.”

“HPSA status can also change immigration laws,” he said. “A provision in immigration laws allows people to get a special visa if they are a qualified health professional coming to work in one of these areas. The work we did had an impact on the ability of eight counties to address their needs for talented health care workers.”

All of the information produced by the project partners will continue to help Wisconsin train the talent it will need to meet the growing need for health care.

“We believed that, by building up the health care and public health infrastructure,” Layde said, “we could help many people in the future.”

Layde and the project partners saw that planning for this future starts now. Through this project, they improved the quality of the information available to those who will guide and shape that future.